Effects of proprioceptive training for people with stroke: A meta-analysis of randomized controlled trials

2021 ◽  
pp. 026921552110576
Author(s):  
Renny Wulan Apriliyasari ◽  
Pham Van Truong ◽  
Pei-Shan Tsai
Keyword(s):  
Randomized Controlled Trials ◽  
Gait Speed ◽  
Meta Analysis ◽  
Functional Mobility ◽  
Controlled Trials ◽  
Balance Performance ◽  
Trunk Control ◽  
Randomized Controlled ◽  
Statistical Heterogeneity ◽  
Proprioceptive Training

Objective To evaluate the effectiveness of proprioceptive training on balance performance, trunk control, and gait speed in people with stroke. Methods We searched PubMed, Science Direct, Cochrane, Embase, and Medline for randomized controlled trials that evaluated the effects of proprioceptive training for patients with stroke from the date of each database's inception to July 26, 2021. Two reviewers independently screened the titles and abstracts of potentially eligible articles that were identified on the basis of the search criteria. Methodological quality was determined using version 2 of the Cochrane risk of bias tool for randomized trials. Data were analyzed using Comprehensive Meta-Analysis software. The treatment effect was estimated by calculating Hedges’ g and 95% confidence intervals (CIs) using a random-effects model. Statistical heterogeneity was assessed according to the I2 value. The primary outcome was balance performance and secondary outcomes were trunk control, gait speed, and basic functional mobility. Results In total, 17 trials involving 447 people with stroke were included. Proprioceptive training had a significant effect on balance performance (Hedges’ g = 0.69, 95% CI = 0.36–1.01), gait speed (Hedges’ g = 0.57, 95% CI = 0.19–0.94), trunk control (Hedges’ g = 0.75, 95% CI = 0.33–1.17), and basic functional mobility (Hedges’ g = 0.63, 95% CI = 0.31–0.94) among people with stroke. Conclusion Proprioceptive training may be effective in improving balance performance, gait speed, trunk control, and basic functional mobility among people with stroke.

Evidence from systematic reviews of randomized trials on enteral lactoferrin supplementation in preterm neonates

2020 ◽  
Author(s):  
Mohan Pammi ◽  
Geoffrey A. Preidis ◽  
William O Tarnow-mordi
Keyword(s):  
Randomized Controlled Trials ◽  
Late Onset ◽  
Meta Analysis ◽  
Current Evidence ◽  
Preterm Neonates ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Late Onset Sepsis ◽  
Statistical Heterogeneity ◽  
Tract Infections

In this commentary, we summarize the current evidence from randomized controlled trials on enteral lactoferrin supplementation in preterm neonates. Our recently completed systematic review includes 12 randomized controlled trials performed all over the world. Our meta-analysis suggests clinical benefit in decreasing late-onset sepsis, late-onset fungal sepsis, length of stay in the hospital and urinary tract infections. There were no adverse effects. There was no statistically significant decrease in necrotizing enterocolitis, mortality or neurodevelopmental impairment in lactoferrin supplemented preterm infants. There was significant statistical heterogeneity in the effects of lactoferrin on late-onset sepsis between larger and smaller studies, which may reflect either small study biases, differences in the effectiveness, dose or duration of supplemental lactoferrin products, or differences in underlying population risk, or any or all of these.

scholarly journals Proprioceptive Training and Outcomes of Patients With Knee Osteoarthritis: A Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Vol 54 (4) ◽  
pp. 418-428 ◽  
Author(s):  
Hee Seong Jeong ◽  
Sung-Cheol Lee ◽  
Hyunseok Jee ◽  
Jun Bom Song ◽  
Hyun Sik Chang ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Level Of Evidence ◽  
Knee Oa ◽  
Randomized Controlled ◽  
Proprioceptive Training ◽  
Evidence Database ◽  
Based Medicine ◽  
Test Outcomes

Objective To describe the effects of proprioceptive training on pain, stiffness, function, and functional test outcomes among patients with knee osteoarthritis (OA). Data Sources All studies completed from 1946 to 2017 were obtained from 4 databases (PubMed, MEDLINE, CINAHL, and SPORTDiscus). Study Selection Three reviewers independently identified appropriate studies and extracted data. Data Extraction Methodologic quality and level of evidence were assessed using the Physiotherapy Evidence Database scale and Oxford Centre for Evidence-Based Medicine guidelines. The standardized mean differences (SMDs) and 95% confidence intervals (CIs) were calculated for pain, stiffness, function, and functional test outcomes. Data Synthesis Seven randomized controlled trials involving 558 patients with knee OA met the inclusion criteria. The selected studies had Physiotherapy Evidence Database scores of 6 to 8. All randomized controlled trials had an Oxford Centre for Evidence-Based Medicine level of evidence of 2. Meta-analysis of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale (SMD = −0.56; 95% CI = −1.06, −0.07; P = .026), function subscale (SMD = −0.40; 95% CI = −0.59, −0.21; P < .001), and non-WOMAC walking speed test (SMD = −1.07; 95% CI = −2.12, −0.01; P = .048) revealed that proprioceptive training had significant treatment effects. Proprioceptive training was not associated with reductions in WOMAC stiffness subscale scores and did not improve non-WOMAC get-up-and-go scores. Conclusions Proprioceptive training effectively promoted pain relief and completion of functional daily activity among patients with knee OA and should be included in rehabilitation programs. Stiffness and other mobility measures were unchanged after proprioceptive training. Modified proprioceptive training programs are needed to target stiffness and improve additional physical function domains.

scholarly journals Effect of N-methyl-d-aspartate receptor enhancing agents on cognition in dementia: an exploratory systematic review and meta-analysis of randomized controlled trials

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chun-Hung Chang ◽  
Chieh-Yu Liu ◽  
Shaw-Ji Chen ◽  
Hsin-Chi Tsai
Keyword(s):  
Cognitive Function ◽  
Nmda Receptor ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Disease Assessment ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Randomized Controlled ◽  
Statistical Heterogeneity ◽  
Agent Treatment

AbstractMultiple N-methyl-d-aspartate (NMDA) receptor enhancing agents have had promising effects on cognition among patients with dementia. However, the results remain inconsistent. This exploratory meta-analysis investigated the effectiveness of NMDA receptor enhancing agents for cognitive function. PubMed, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews were searched for randomized controlled trials (RCTs). Controlled trials assessing add-on NMDA receptor enhancing agent treatment in patients with dementia and using cognition rating scales were eligible and pooled using a random-effect model for comparisons. The standardized mean difference (SMD) was calculated in each study from the effect size; positive values indicated that NMDA receptor enhancing agent treatment improved cognitive function. Funnel plots and the I2 statistic were evaluated for statistical heterogeneity. Moderators were evaluated using meta-regression. We identified 14 RCTs with 2224 participants meeting the inclusion criteria. Add-on NMDA receptor enhancing agents had small positive significant effects on overall cognitive function among patients with dementia (SMD = 0.1002, 95% CI 0.0105–0.1900, P = 0.02860). Subgroup meta-analysis showed patients with Alzheimer’s Disease and trials using the Alzheimer Disease Assessment Scale-cognitive subscale as the primary outcome had small positive significant effects (SMD = 0.1042, 95% CI 0.0076–0.2007, P = 0.03451; SMD = 0.1267, 95% CI 0.0145–0.2388, P = 0.2686). This exploratory meta-analysis showed a very small, positive, and significant effect on overall cognition function in patients with dementia. Studies with larger samples are needed to evaluate different cognitive domains and phases of dementia.

scholarly journals Traditional Chinese Mind and Body Exercises for Neck Pain: A Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Yu-Hua Xie ◽  
Man-Xia Liao ◽  
Mao-Yuan Wang ◽  
W. C. Hewith A. Fernando ◽  
Yue-Ming Gu ◽  
...  
Keyword(s):  
Neck Pain ◽  
Randomized Controlled Trials ◽  
Pain Intensity ◽  
Short Form ◽  
Meta Analysis ◽  
Functional Mobility ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Sf 36 ◽  
Mind And Body

Background. Neck pain is common and can have a significant impact on patients’ physical functionality, mobility, and quality of life (QOL). In clinical practice, traditional Chinese mind and body exercise (TCMBE) is a combination of different types of exercise based on traditional Chinese medicine, including qigong, tai chi, the 12-words-for-life-nurturing exercise, and so on, and many studies have found that it is safe and effective at helping patients with neck pain. Objective. The aim of this study was to investigate the effectiveness of TCMBE on pain intensity, functional mobility, and QOL in individuals with neck pain. Methods. The PubMed, MEDLINE, PEDro, and Embase databases were systematically searched for relevant studies. Randomized controlled trials reporting the effects of TCMBE on pain intensity, functional mobility, and QOL in individuals with neck pain were included. Screening, data extraction, and literature quality assessments were performed independently by two reviewers. RevMan5.4 software was used for data analysis. Results. Six studies with 716 participants met the inclusion criteria. Compared with the control groups, TCMBE had no therapeutic advantage in improving pain intensity (visual analogue scale: mean difference (MD) = 1.8, 95% confidence interval (CI): −7.70 to 11.46, and P  = 0.70); functional mobility (neck disability index: MD = 0.15, 95% CI: −6.37 to 6.66, and P  = 0.96; neck pain and disability scale: MD = 1.31, 95% CI: −4.10 to 6.71, and P  = 0.64); or 36-item short-form health survey (SF-36) scores for physical function (MD = 5.58, 95% CI: −8.03 to 19.18, and P  = 0.42), general health (MD = 1.87, 95% CI: −4.99 to 8.72, and P  = 0.59), body pain (MD = 2.26, 95% CI: −3.80 to 8.32, and P  = 0.46), vitality (MD = 6.24, 95% CI: −1.49 to 13.98, and P  = 0.11), social function (MD = 8.06, 95% CI: −4.85 to 20.98, and P  = 0.22), role physical (MD = –1.46, 95% CI: −8.54 to 5.62, and P  = 0.69), or role emotional (MD = 6.5, 95% CI: −3.45 to 16.45, and P  = 0.2). However, TCMBE was less effective at improving mental health results based on the SF-36 survey (MD = 3.37, 95% CI: 0.5 to 6.24, and P  = 0.02). Conclusions. Based on the meta-analysis, there is insufficient evidence to support the clinical use of TCMBE in improving pain intensity and enhancing functional mobility and QOL in individuals with neck pain.

Electroacupuncture for the treatment of perimenopausal syndrome: a systematic review and meta-analysis of randomized controlled trials

2021 ◽  
pp. 096452842110557
Author(s):  
Zhiyan Zhong ◽  
Haoxu Dong ◽  
Hui Wang ◽  
Yao Huang ◽  
Dongmei Huang ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Serum Levels ◽  
Effective Rate ◽  
Evidence Base ◽  
Controlled Trials ◽  
Hot Flushes ◽  
Randomized Controlled ◽  
Statistical Heterogeneity ◽  
Perimenopausal Syndrome

Objective: To assess the efficacy, comparative effectiveness and safety of electroacupuncture (EA) in the treatment of perimenopausal syndrome (PMS). Methods: Nine databases were searched until June 2019. Only relevant randomized controlled trials (RCTs) of EA for PMS were included. Results: Twelve trials involving 746 women were included. EA and hormone therapy (HT) did not significantly differ in terms of effective rate (risk ratio (RR) = 0.98, 95% confidence interval (CI) = 0.93 to 1.04), Kupperman index (KI) (mean difference (MD) = −0.25, 95% CI = −0.76 to 0.26) and serum levels of follicle-stimulating hormone (FSH) (MD = −3.80, 95% CI = −11.59 to 3.98) or luteinizing hormone (LH) (MD = −2.51, 95% CI = −10.72 to 5.70). Serum estradiol (E2) levels were significantly lower in EA versus HT groups (MD = −60.58, 95% CI = −71.93 to −49.23). Compared with sham EA, EA had a significantly greater effect on reductions in KI (MD = −4.71, 95% CI = −6.57 to −2.86) and hot flushes score/24 h (MD = −2.43, 95% CI = −2.93 to −1.93). There were no significant differences between EA and manual acupuncture (MA) in terms of effective rate (RR = 1.14, 95% CI = 0.98 to 1.33) or serum FSH (MD = −2.87, 95% CI = −29.65 to 23.91), LH (MD = 2.73, 95% CI = −9.65 to 15.11) or E2 (MD = 26.80, 95% CI = −12.06 to 65.65). However, it seemed that EA had a better effect than MA on KI (MD = −2.44, 95% CI = −4.80 to −0.08). Subgroup analyses indicated that EA may have more of a benefit in the pre-menopausal state (hot flushes score/24 h: MD = −1.66, 95% CI = −3.49 to 0.17) compared to post-menopause (p > 0.05). Conclusion: The effect of EA appeared broadly similar to HT and MA in the treatment of PMS, although EA-associated reductions in KI were superior to MA and sham EA, suggesting effects beyond placebo. The evidence base is limited by a small number of eligible studies, risk of bias and clinical/statistical heterogeneity, limiting our ability to draw firm conclusions. As such, additional larger scale, high-quality RCTs are needed.

scholarly journals The Role of Prophylactic Octreotide Following Pancreaticoduodenectomy to Prevent Postoperative Pancreatic Fistula: A Meta-Analysis of the Randomized Controlled Trials

2018 ◽  
Vol 04 (04) ◽  
pp. e182-e187 ◽  
Author(s):  
Pankaj Garg ◽  
Jyoti Sharma ◽  
Ashish Jakhetiya ◽  
Nilokali Chishi
Keyword(s):  
Randomized Controlled Trials ◽  
Pancreatic Fistula ◽  
Meta Analysis ◽  
Postoperative Pancreatic Fistula ◽  
P Value ◽  
Controlled Trials ◽  
Significant Heterogeneity ◽  
Randomized Controlled ◽  
Statistical Heterogeneity

Introduction A postoperative pancreatic fistula (POPF) is a major cause of morbidity and mortality following pancreaticoduodenectomy (PD). A pharmacologic approach using perioperative octreotide, a long-acting somatostatin analog having an inhibitory action on pancreatic exocrine secretion, was proposed to reduce the incidence of the POPF. Despite contradictory results in various randomized controlled trials (RCTs), the prophylactic octreotide has been widely used in the last two decades to reduce the POPF. The present meta-analysis aims to assess the effectiveness of the prophylactic octreotide in preventing the POPF following PD. Methods A literature search was performed in the PubMed for the RCTs that compared the prophylactic octreotide with the placebo following PD published prior to October 2016. Review manager (Cochrane Collaboration's software) version RevMan 5.2 was used for analysis. Those RCTs which had compared the prophylactic Octreotide with placebo to reduce the POPF following PD were considered eligible for the meta-analysis. The low quality (Jadad score of two or less) RCTs or those including mixed pancreatic resections without reporting specific pancreaticoduodenectomy outcomes were excluded. The effect size for the dichotomous and the continuous data was displayed as the odds ratio (OR) and the weighted mean difference (WMD), respectively, with their corresponding 95% confidence intervals (CI). A fixed effect or random effects model was used to pool the data according to the result of a statistical heterogeneity test. The heterogeneity between the studies was evaluated using the Cochran Q statistic and the I 2 test, with p < 0.05 indicating significant heterogeneity. Results There were eight RCTs available for the analysis. A total of 959 patients were included in the meta-analysis–492 received the prophylactic octreotide and 467 patients received the placebo. The prophylactic octreotide was not found to significantly decrease the total number of the POPF (OR, 1.03'; 95% CI: 0.73–1.45; p-value 0.85) or the clinically significant POPF (OR, 0.76; 95% CI: 0.35–1.65; p-value 0.49) compared with the placebo. There was also no difference in the duration of hospital stay (WMD, 1.19; 95% CI:1.84–4.23; p-value 0.44) or the postoperative mortality (OR, 2.04; 95% CI: 0.87–4.78; p-value 0.10) between the two groups. The prophylactic octreotide was also not found to significantly delay the gastric emptying (OR, 0.76; 95% CI: 0.41–1.40; p-value 0.38). Conclusion The present meta-analysis does not support the role of the prophylactic octreotide to prevent the POPF following PD.

scholarly journals Association Between Vitamin D and Influenza: Meta-Analysis and Systematic Review of Randomized Controlled Trials

2022 ◽  
Vol 8 ◽  
Author(s):  
Zhixin Zhu ◽  
Xiaoxia Zhu ◽  
Lanfang Gu ◽  
Yancen Zhan ◽  
Liang Chen ◽  
...  
Keyword(s):  
Vitamin D ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Study Finding ◽  
Vitamin D Supplementation ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Significant Heterogeneity ◽  
Randomized Controlled ◽  
Statistical Heterogeneity

Background: Vitamin D supplementation improves the immune function of human body and can be a convenient way to prevent influenza. However, evidence on the protective effect of vitamin D supplementation on influenza from Randomized Controlled Trials (RCTs) is inconclusive.Methods: RCTs regarding the association between vitamin D supplementation and influenza were identified by searching PubMed, Cochrane library, Embase and Chinese Biomedical Database (CBM) from inception until present (last updated on 10 November 2021). Studies that reported dosages and durations of vitamin D supplementation and number of influenza infections could be included. Heterogeneity was assessed using Cochran's Q test and I2 statistics, the meta-analysis was conducted by using a random-effects model, the pooled effects were expressed with risk ratio (RR) with 95% confidence interval (95% CI).Results: 10 trials including 4859 individuals were ultimately eligible after scanning. There was no evidence of a significant heterogeneity among studies (I2 = 27%, P = 0.150). Meta-regression analysis finding indicated that country, latitude, average age, economic level, follow-up period and average daily vitamin D intake did not cause the statistical heterogeneity. The study finding indicates that substitution with vitamin D significantly reduces the risk of influenza infections (RR = 0.78, 95% CI:0.64–0.95). No evidence of publication bias was observed. Omission of any single trial had little impact on the pooled risk estimates.Conclusions: The meta-analysis produced a corroboration that vitamin D supplement has a preventive effect on influenza. Strategies for preventing influenza can be optimized by vitamin D supplementation.

scholarly journals Proprioceptive Training for Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 8 ◽  
Author(s):  
Yi Wang ◽  
Zugui Wu ◽  
Zehua Chen ◽  
Xiangling Ye ◽  
Guoqian Chen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Knee Osteoarthritis ◽  
Randomized Controlled Trials ◽  
Physical Function ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Proprioceptive Training ◽  
Conventional Physiotherapy

Background: There is increased interest in proprioceptive training for knee osteoarthritis (KOA). However, little consensus supports the effectiveness of this intervention.Objective: This meta-analysis aimed to assess the effects of proprioceptive training on symptoms, function, and proprioception in people with KOA.Methods: The PubMed, Cochrane Library, Web of Science, and EMBASE databases were systematically searched from the inception dates to April 16, 2021 for relevant randomized controlled trials (RCTs). Data were pooled by calculating the standardized mean differences (SMDs) and 95% confidence intervals (CIs). A random-effects model was used for the analyses.Results: A total of 24 RCTs involving 1,275 participants were included in our analysis. This study indicated that compared to no intervention, proprioceptive training significantly improved pain, stiffness, physical function, joint position sense (JPS), muscle strength, mobility, and knee ROM (P &lt; 0.05) in people with KOA. When compared to other non-proprioceptive training, proprioceptive training provided better results in terms of JPS (SMD = −1.28, 95%CI: [−1.64, −0.92], I2 = 0%, P &lt; 0.00001) and mobility (timed walk over spongy surface) (SMD = −0.76, 95%CI: [−1.33, −0.18], I2 = 64%, P = 0.01), and other results are similar. When proprioceptive training plus other non-proprioceptive training compared to other non-proprioceptive training, the two groups showed similar outcomes, but there was a greater improvement for JPS (SMD = −1.54, 95%CI: [−2.74, −0.34], I2 = 79%, P = 0.01), physical function (SMD = −0.34, 95%CI: [−0.56, −0.12], I2 = 0%, P = 0.003), and knee ROM (P &lt; 0.05) in the proprioceptive training plus other non-proprioceptive training group. When proprioceptive training plus conventional physiotherapy compared against conventional physiotherapy, the two groups demonstrated similar outcomes, but there was a significant improvement for JPS (SMD = −0.95, 95%CI: [−1.73, −0.18], I2 = 78%, P = 0.02) in the proprioceptive training plus conventional physiotherapy group.Conclusions: Proprioceptive training is safe and effective in treating KOA. There is some evidence that proprioceptive training combined with general non-proprioceptive training or conventional physiotherapy appears to be more effective and should be considered as part of the rehabilitation program. However, given that the majority of current studies investigated the short-term effect of these proprioceptive training programs, more large-scale and well-designed studies with long-term follow up are needed to determine the long-term effects of these proprioceptive training regimes in KOA.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/#recordDetails, PROSPERO, identifier: CRD42021240587.

Therapeutic effect of erythropoietin in patients with traumatic brain injury: a meta-analysis of randomized controlled trials

2017 ◽  
Vol 127 (1) ◽  
pp. 8-15 ◽  
Author(s):  
Wen-Chao Liu ◽  
Liang Wen ◽  
Tao Xie ◽  
Hao Wang ◽  
Jiang-Biao Gong ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Hospitalization Time ◽  
Statistical Heterogeneity ◽  
Significant Difference

OBJECTIVEErythropoietin (EPO) exerts a neuroprotective effect in animal models of traumatic brain injury (TBI). However, its effectiveness in human patients with TBI is unclear. In this study, the authors conducted the first meta-analysis to assess the effectiveness and safety of EPO in patients with TBI.METHODSIn December 2015, a systematic search was performed of PubMed, Web of Science, MEDLINE, Embase, the Cochrane Library databases, and Google Scholar. Only English-language publications of randomized controlled trials (RCTs) using EPO in patients with TBI were selected for analysis. The assessed outcomes included mortality, favorable neurological outcome, hospital stay, and associated adverse effects. Continuous variables were presented as mean difference (MD) with a 95% confidence interval (CI). Dichotomous variables were presented as risk ratio (RR) or risk difference (RD) with a 95% CI. Statistical heterogeneity was examined using both I2 and chi-square tests.RESULTSOf the 346 studies identified in the search, 5 RCTs involving 915 patients met the inclusion criteria. The overall results demonstrated that EPO significantly reduced mortality (RR 0.69, 95% CI 0.49–0.96, p = 0.03) and shortened the hospitalization time (MD −7.59, 95% CI −9.71 to −5.46, p < 0.0001) for patients with TBI. Pooled results of favorable outcome (RR 1.00, 95% CI 0.88–1.15, p = 0.97) and deep vein thrombosis (DVT; RD 0.00, 95% CI −0.05 to 0.05, p = 1.00) did not show a significant difference.CONCLUSIONSThe authors suggested that EPO is beneficial for patients with TBI in terms of reducing mortality and shortening hospitalization time without increasing the risk of DVT. However, its effect on improving favorable neurological outcomes did not reach statistical significance. Therefore, more well-designed RCTs are necessary to ascertain the optimum dosage and time window of EPO treatment for patients with TBI.

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